AREU Lombardia Regional Emergency Service, Milan, Italy.
Eur J Emerg Med. 2013 Apr;20(2):72-8. doi: 10.1097/MEJ.0b013e328358e336.
This topic highlights the results of the literature review on calcium therapy during cardiac arrest and cardiopulmonary resuscitation according to the Patient/population, Intervention, Comparator, Outcome structure. Eligible studies were assigned to one of the five levels of evidence. Their quality was rated as either good, fair, or poor and then classified as supportive, neutral, or opposing according to the outcome benefits. Among the 48 articles retrieved, 10 articles fulfilled all the criteria for analysis for the Guidelines preparation. There is no evidence that the administration of calcium during cardiopulmonary resuscitation improves survival from cardiac arrest irrespective of the presenting rhythm. In the setting of hyperkalemia, calcium channel blocker intoxication, hypocalcemia, and hypermagnesemia, the role of calcium remains unclear because of the limited amount of evidence. The main limitation is the scarcity of data, most of which relate to anoxic cardiac arrest, accounting for no more than 25% of the causes of cardiac arrest in humans.
本主题根据患者/人群、干预、对照和结局结构,重点介绍了心脏骤停和心肺复苏期间钙治疗的文献综述结果。合格的研究被分配到证据的五个级别之一。根据结局获益,将其质量评为良好、一般或较差,并分类为支持、中性或反对。在检索到的 48 篇文章中,有 10 篇文章完全符合指南制定的分析标准。无论呈现的节律如何,心肺复苏期间给予钙并不能提高心脏骤停患者的存活率,这方面没有证据支持。在高钾血症、钙通道阻滞剂中毒、低钙血症和高镁血症的情况下,由于证据有限,钙的作用仍不清楚。主要限制是数据的缺乏,其中大部分与缺氧性心脏骤停有关,在人类心脏骤停的原因中所占比例不超过 25%。